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Low back pain - acute

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Low back pain refers to pain that you feel in your lower back. You may also have back stiffness, decreased movement of the lower back, and difficulty standing straight.

Acute back pain can last for a few days to a few weeks.

Causes

Most people have at least one backache in their life. Although this pain or discomfort can happen anywhere in your back, the most common area affected is your lower back. This is because the lower back supports most of your body's weight.

Low back pain is the number two reason that Americans see their health care provider -- second only to colds and flu.

You'll usually first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an injury or accident.

Acute low back pain is most often caused by a sudden injury to the muscles and ligaments supporting the back. The pain may be caused by muscle spasms or a strain or tear in the muscles and ligaments.

Symptoms

You may feel a variety of symptoms if you have hurt your back. You may have a tingling or burning sensation, a dull achy feeling, or sharp pain. The pain may be mild, or it can be so severe that you are unable to move.

Depending on the cause of your back pain, you may also have pain in your leg, hip, or the bottom of your foot. You may also have weakness in your legs and feet.

Exams and Tests

Your provider will try to determine the cause of your back pain and whether it is likely to quickly get better with simple measures such as ice, mild painkillers, physical therapy, and proper exercises. Most of the time, back pain will get better using these approaches.

During the physical exam, your health care provider will try to pinpoint the location of the pain and figure out how it affects your movement.

Most people with back pain improve or recover within 4 to 6 weeks. Your provider may not order any tests during the first visit unless you have certain symptoms.

Treatment

To get better quickly, take the right measures when you first feel pain.

Here are some tips for how to handle pain:

Stop normal physical activity for the first few days. This will help relieve your symptoms and reduce any swelling in the area of the pain.

Apply heat or ice to the painful area. One good method is to use ice for the first 48 to 72 hours, and then use heat.

Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).

While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.

A common misbelief about back pain is that you need to rest and avoid activity for a long time. In fact, bed rest is not recommended. If you have no sign of a serious cause for your back pain (such as loss of bowel or bladder control, weakness, weight loss, or fever), then you should stay as active as possible.

You may want to reduce your activity only for the first couple of days. Then, slowly start your usual activities after that. Do not perform activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. After 2 to 3 weeks, you should gradually start exercising again.

Begin with light aerobic training. Walking, riding a stationary bicycle, and swimming are great examples. These aerobic activities can improve blood flow to your back and promote healing. They also strengthen muscles in your stomach and back.

Stretching and strengthening exercises are important. However, starting these exercises too soon after an injury can make your pain worse. A physical therapist can help you know when to begin stretching and strengthening exercises and how to do them.

You may benefit from physical therapy. Your provider will determine whether you need to see a physical therapist and can refer you to one in your area. The physical therapist will first use methods to reduce your pain. Then, the therapist will teach you ways to prevent getting back pain again.

If your pain lasts longer than one month, your primary health care provider may send you to see either an orthopedist (bone specialist) or neurologist (nerve specialist).

If your pain has not improved after use of medicines, physical therapy, and other treatments, your doctor may recommend an epidural injection.

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